Australski znanstvenici istražuju medicinska čuda antičke terapije crvotočinama

Australski znanstvenici istražuju medicinska čuda antičke terapije crvotočinama

Gumb "sljedeći" vjerojatno je najbolja opcija za one čitatelje razborite ili mrzovoljne prirode, jer je ovo vijest koja govori o napretku u drevnoj medicinskoj umjetnosti "terapije crvima" i zašto se ovaj pomalo jezivi tretman ponovno vraća u suvremene terapijske primjene u Australiji.

Doktor Frank Stadler sa Sveučilišta Griffith nedavno je dobio međunarodno priznanje za svoj projekt terapije maggotima koji je "proučavao uporabu crve u terapeutske medicinske svrhe u ratnim zonama i drugim ugroženim zdravstvenim ustanovama". U rujnu ove godine istraživački projekt dr. Stadlera preporučio je Humanitarni veliki izazov Kanada za financiranje u iznosu od 250.000 dolara, a prema članku na ABC.NET -u rekao je,

"Crvi su fantastični ... Uklanjaju mrtvo tkivo ... Steriliziraju rane ... Pojedi svo mrtvo i trulo tkivo u rani."

Upotrebu crva u medicinskim tretmanima neovisno je razvilo diljem svijeta u posljednjih 1000 godina nekoliko drevnih kultura, na primjer: narod brda iz Sjevernog Mjanmara (Burma) i iscjelitelji Maja iz Srednje Amerike, te starosjedilačko pleme Ngemba Novi Južni Wales u Australiji. U radu objavljenom u američkoj Nacionalnoj medicinskoj biblioteci, koji je napisao tim istraživača pod vodstvom dr. Iaina S Whitakera, Odjela za opekline i plastičnu kirurgiju, bolnica Morriston, Swansea, UK, stoji:

"Povezanost ličinki sa zaraženim ranama zabilježena je od davnina, a Stari zavjet je najstariji pisani dio koji navodi zaraženost zaražene čovjeka ličinkama mušica (mijaza)."

Terapija dezinfekcijskog lijeka na rani na dijabetičkom stopalu. (CC BY-SA 3.0)

U Australiji su lijekovi crvotočina starih autohtonih zajednica oživjeli tijekom Prvog i Drugog svjetskog rata. "Uklanjaju bakterije jedući ih i probavljajući ih, te kroz izlučevine i izlučevine koje stavljaju u ranu ... Dakle, imaju antimikrobna svojstva ... To kontrolira infekciju dovoljno da tijelo zacijeli ranu", rekao je dr. Stadler novinarima. Dodao je da je iz tih razloga "U posljednje vrijeme, od Prvog svjetskog rata, terapija crvcima korištena je u suvremenim kliničkim okruženjima."

Drevne vještine iscjeljivanja medicinskih crva

Crvi se mogu nanositi izravno na rane, maksimalno dva do četiri dana, s mrežastom oblogom poput „mrežice protiv muha“ kako bi se crvi zadržali na zahvaćenom području, ili se mogu „zatvoriti u vrećicu nalik vrećici čaja“ i stavljaju na ranu, što znači da se mogu primijeniti nježno i bez uvreda ”, kaže dr. Stadler. "Ovo funkcionira jer crvi nemaju usta za žvakanje, prvo izlučuju mrtvo tkivo izlučevinama, a zatim usisavaju hranu", dodao je. Nakon uklanjanja obloga od mrtvih crve, mogu se ponovno nanijeti novi crvi.

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Za razliku od gusjenica, crvi nemaju usta za žvakanje. ( Ezume Images /Adobe Stock)

Istraživački tim vjeruje da bi njihov rad mogao ne samo "dati stvarni doprinos u zaštiti života i zaštiti rana u udovima u sukobu", već i da bi se "vrijednost skromnog ličinka povećala kako se otpornost na antibiotike povećava u zajednici". Kako se ljudi razvijaju, razvijamo rezistenciju na antibiotike, a prema dr. Stadler, dok se „penicilin gubi na snazi“, terapija crvuljkama se pokazala „učinkovitom u infekcijama rezistentnim na antibiotike, poput stafilokoka“.

Znači li to da ako vas hakiraju igrajući nogomet i prerežete potkoljenicu, sada možete ući u ordinaciju svog doktora s vrećicom crva i zamoliti ih da ih primijene u liječenju? Pa, da, zapravo jest, ali biste mogli očekivati ​​da će vaš liječnik isprva pokazati otpor. Međutim, dr. Stadler rekao je novinarima da:

"U mnogim slučajevima danas, kada ljudi dolaze u bolnicu s ranama zaraženim crvuljicama, zdravstveni djelatnici moraju priznati da rane izgledaju savršeno, izgledaju dobro."

Crvi koji su se koristili u kliničkim ispitivanjima dr. Stadlera posebno su sterilizirani: „Beremo crve iz divljine. Zatim osnivamo koloniju, koloniju muha, zatim se kolonija muha održava, jaja se beru na sterilni način, tako da su larve koje izlaze iz jaja sterilne kada se stavljaju na rane koje zahtijevaju liječenje ”, rekao je. Međutim, trenutno u Australiji, bolnica Westmead u Sydneyu jedini je odobreni pružatelj steriliziranih medicinskih crva i opslužuje pacijente s ekstremnim medicinskim slučajevima koji nastoje poboljšati uobičajene tretmane.

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Crvi u medicinskom pakiranju. ( CC BY-SA 4.0 )

Terapija s crvima nudi nadu dijabetičarima

Medicinski tretmani autohtonog podrijetla često uključuju primjenu, a ponekad je probava smrvljenih insekata, kornjaša, životinja i ptica i primjena takvih lijekova jednostavno "ne ne" kod velike većine javnosti. Prema dr. Stadler -u, terapija crvuljkama “smatrana je lijekom u posljednjoj instanci u Australiji ... ali idealno je prikladna za rane intervencije”. Predlažući primjer gdje bi terapija crvuljkama mogla pomoći u primarnim fazama liječenja, dr. Stadler je rekao: "Kad se kod nekoga pojavi dijabetesni ulkus, terapija ličinkama je fantastična u liječenju tog ulkusa i postavljanju rane za zacjeljivanje."

Peter Lazzarini, glavni istraživač na QUT-u i supredsjedatelj Diabetic Foot Australia, rekao je novinarima na ABC.AU-u da je "nekolicina malih studija testirala terapiju crvima na pacijentima s dijabetičkim stopalom sa mješovitim rezultatima." Dodao je: "Obrazloženje korištenja terapije ličinkama obećava, ali potrebna su nam veća istraživanja da bismo dokazali je li ona još učinkovitija ili učinkovitija od ostalih oblika debridmana."


Bruto medicina: prije stotina godina, crvi i pijavice bili su sastavni dio "ormara za lijekove". Sada je staro opet novo: spremni ste ih isprobati? (Znanost o životu: krvožilni sustav).

Ošamućeni mladić nedavno je naletio u Pensacolu, baptističku bolnicu na Floridi, obilno krvareći zbog zjapeće rane na licu. "Izgubio je komadić nosa", kaže plastični kirurg dr. Ian Rogers. "Viselo je s ovog malog mesnatog preklopa." Rogers je izveo osjetljivu mikrokirurgiju kako bi zašio (spojio) pacijentove osjetljive živce, krvne žile i kožno tkivo-ponovno pričvrstivši vrh nosa.

Činilo se da je operacija uspjela, sve dok nos nije natekao i postao ljubičast poput grožđa. Problem: Krv je tekla u ponovno vezano meso kroz žile koje se zovu arterije, ali vene nisu transportirale krv dovoljno brzo iz tog područja. Stanje, poznato kao venska kongestija, često se javlja nakon rekonstruktivne operacije, jer su oštećene vene tankih stijenki i teško ih je popraviti. Da bih uklonio zagušenu krv, "odlučio sam da mu moramo staviti pijavicu na nos", kaže Rogers.

Je li lud. Nema šanse. Kad dođe do venske kongestije, liječnik mora brzo vratiti cirkulaciju ili će u protivnom tkivo umrijeti. Unesite pijavice, vrstu crva koji siše krv. "Uvijek imamo oko pola tuceta dječaka pri ruci u hladnjaku", kaže Rogers. "Ako ništa drugo ne uspije, pozivamo crve."

Možda će vam se okrenuti želudac, ali suvremeni liječnici diljem zemlje bacaju novi pogled na ljekovitu moć "narodnih" lijekova poput pijavica i crva (ličinke muha slične gusjenicama). Ovi jezivi puhovi stoljećima su bili standardna medicinska hrana, sve dok ih znanstveni napredak nije zamijenio: Krajem 19. stoljeća teorija sepse je smatrala da čuvanje rana i instrumenata bez klica potiče zacjeljivanje. Otkrića u dvadesetom stoljeću-poput antibiotika ili lijekova za uništavanje klica-gotovo su izbacili narodne lijekove iz modernih bolnica.

Sada, "gotovo slučajno učimo da su prirodni lijekovi-često nazvani" bruto "-ponekad najbolji", kaže Michele Root-Bernstein, autorica knjige Med, blato, crvi i druga medicinska čuda.

I danas, kao i u prošlosti, liječnici koriste crv da pojedu mrtvo tkivo i očiste zaražene rane. U prirodi neke vrste muha polažu jaja u mrtve životinje (leševe). Kad se jaja izlegu u crvolike ličinke, zvane crvi, luče kemijske enzime koji razgrađuju velike molekule na manje, probavljive.

Znanstvenici još ne razumiju kako ti enzimi djeluju, ali tvari otapaju trulo meso u tekućinu koju se crvi guste poput juhe. "Crvi su siti [puni] nakon 48 sati", kaže stručnjak za terapiju ličinkama dr. Ronald Sherman sa Kalifornijskog sveučilišta u Irvineu. Kad se napune, crvi se instinktivno odmiču od trupa i zakopavaju u zemlju kako bi se kukuljili ili postali kukuljica. Kukuljica je neaktivna faza u metamorfozi ili transformaciji mnogih insekata, slijedi stadij larve i prethodi fazi odrasle osobe. Tijekom stadija kukuljice, ličinke se pretvaraju u odrasle muhe unutar zaštitnih čahura.

Tijekom građanskog rata i Prvog svjetskog rata muhe su prirodno vukle u bolnice na bojnom polju i ponekad su polagale jaja u trulo meso vojničkih rana. Začuđeni vojni liječnici primijetili su da rane zaražene crvcima imaju tendenciju boljeg zacjeljivanja od nezaraženih rana. Rođena je terapija crvima.

Danas liječnici u 280 američkih medicinskih centara prepisuju crvi za liječenje inficiranih dekubitusa (rana na krevetu), opeklina, čireva na nogama i stopalima, ubodnih rana i postoperativnih rana koje odbijaju zacijeliti. "Crvi djeluju brže od bilo koje nekirurške metode za zacjeljivanje rana i nije tako vjerojatno da će ozlijediti zdravo tkivo", kaže Sherman, koji uzgaja ljekovite crvice u "insektu".

Tamo muhari (Phaenicia sericata) "upuhuju" do 2000 jaja odjednom na ploške sirove jetre. Tehničari operu jaja u sredstvu za dezinfekciju i stave ih u sterilnu posudu (bez mikroba) kako bi se ličinke izlegle u okruženju bez bakterija. U prirodi se larve muha izležu u trulom životinjskom mesu prepunom bakterija. No, samo su crvi koji se hrane laboratorijski steriliziranim mesom dovoljno čisti za medicinsku uporabu.

Kad pacijent ima, recimo, veliku ranu na nozi koja ne zacjeljuje unatoč operaciji i mjesecima-ili godinama-liječenja antibiotskim mastima i sredstvima za čišćenje, ostaju dvije mogućnosti: amputacija ili terapija crvuljima. Koje biste odabrali?

Liječenje započinje kada liječnik stavi sterilne ličinke muhe-ne više od 8 po četvornom centimetru-izravno u ranu i prekrije je "kavezom" od najlonske mreže kako bi spriječio da se crvi uklone. Liječnik zatim navlači upijajuću gazu na kavez kako bi održao ličinke vlažnima i upio sve ukapljeno mrtvo meso. Crvi djeluju na tri ključna načina na ranu, kaže Sherman: "Debride [uklanjaju mrtvo, zaraženo tkivo], dezinficiraju i potiču zdrav rast tkiva."

Otprilike 48 sati nakon nanošenja, liječnik vadi crvice vlažnom gazom i odbacuje ih s ostalim zaraznim medicinskim otpadom, koji se obično spaljuje (spaljuje). U nedavnoj studiji, istraživači su otkrili da prosječna rana na nozi ili stopalu liječena crvom pokazuje zdrav rast tkiva u roku od tri tjedna (vidi grafikon, str. 9).

Utječe li pojam terapije crvotočinama na koži kod pacijenata? "Nikada nikoga nisam izluđivao-čak ni onih kojima je ta ideja u početku ogorčena", kaže plastična kirurginja dr. Jane Petro iz Medicinskog centra okruga Westchester u Valhali u New Yorku.

Ako vas pomisao na grčenje crva po tijelu tjera na trzanje, što kažete na pijavice koje piju krv? Stoljećima su liječnici primjenjivali pijavice (Hirudo medicalis) za krvoproliće ili flebotomiju za koju su pogrešno mislili da gubitak krvi liječi tijelo dopuštajući nečistoćama i višku tekućine da iscuri.

Danas, kada je u pitanju obnova cirkulacije krvi nakon rekonstruktivne operacije, "pijavice su vrlo učinkovite", kaže dr. Donald Mackay s Medicinskog fakulteta Sveučilišta Pennsylvania. Zašto? Jedan crv nalik na puža može progutati i do pet puta veću tjelesnu težinu od krvi! Ljekovita pijavica, jedna od 650 vrsta pijavica, crv je mesožder (meso i krv koja jede krv) dugačak 10 centimetara (4 inča), prirodno se nalazi u europskim močvarama i jezercima. Pijavica ima sisaljku na svakom kraju, a manji ima stotine zuba (vidi dijagram, lijevo). Iznenađujuće, ubod pijavice ne boli. To je zato što slina crva sadrži prirodni anestetik ili lijek protiv bolova.

Slina pijavica također sadrži hirudin, tvar koja sprječava zgrušavanje krvi. Tijekom 30-minutnog hranjenja, pijavica može izvući 30 mililitara krvi-punih oko 5 ili 6 naprstaka. Pijavica tada pada kako bi probavila svoj obrok. No, kaže Ian Rogers, "zahvaljujući hirudinu, ugriz zadržava krvarenje i potiče cirkulaciju 12 do 15 sati." Pijavice također proizvode vazodilatator, odnosno tvar koja otvara krvne žile. "Pijavice su poput mini drogerije", kaže Anna Baldwin iz Centra za pijavice Biopharm u Charlestonu u Južnoj Karolini.

Što je sa strpljivošću pacijenata? Kad ponovno spojeni prst natekne od krvi zbog zapušenosti vena, izbor je jednostavan, kaže dr. Jeffrey Friedman, plastični kirurg s Baylor College of Medicine u Houstonu: "Možemo vam ponovno odrezati prst ili upotrijebiti pijavicu." Dodaje Donald Mackay: "Nikada nijedan pacijent nije odbio liječenje. Jedan pacijent čak je pijavicama dao imena!"

LJEKOVITE RANE: MAGGOTS PROTIV ANTIBIOTIKA

U studiji na 103 pacijenta, rane liječene crvcima zacjeljivale su se i smanjivale se brže od rana liječenih antibioticima.

Nekrotično (mrtvo) tkivo ispunjava čireve na koži pacijenta (lijevo). Otvorene rane nisu reagirale na IV (intravenozne) antibiotike. Tri mjeseca nakon terapije crvotočinama (desno), nekrotično tkivo zamjenjuje zdrava nova koža.

U prirodi ljekovita pijavica vreba u europskim jezercima, gdje se hrani krvlju samo jednom svakih 18 mjeseci.

NEKA TEKE: Znanstvenici ekstrahiraju lijek orgelazu iz sline pijavica. Proširuje krvne žile, povećavajući protok krvi.

Nakon čitanja članka odaberite točan odgovor na ova pitanja:

BOLJE OD STVARNOG?

Mnogi se liječnici slažu: Ništa nije bolje od pijavice koja potiče protok krvi u oštećenom tkivu. No, ne sviđa se svaki pacijent ideji, kaže kirurg sa Sveučilišta Wisconsin dr. Gregory Hartig. Zato je Hartig, zajedno s Michaelom Confortijem i Nadine Connor, izumio sićušni gadget za sisanje krvi koji oponaša vrckavu pijavicu. "U slučaju liječenja pijavicama možemo poboljšati prirodu", kaže Connor. Je li pijavica ispunila svoju mehaničku podudarnost?

Osim elegantnog, kliničkog dizajna, mehanička pijavica nikada se ne napuni i otpadne, pa može ukloniti daleko više krvi od prave. Evo kako to funkcionira:

A Ispod kože pacijenta umetnut je konus obložen teflonom ili "usisavač". Rupe u konusu za usisavanje ispuštaju otopinu za čišćenje.

B Cijev isporučuje lijek protiv odjeće u ranu

C Usisna cijev izvlači krv i otopinu za poticanje cirkulacije.

D Staklena vakuumska komora održava usisavanje.

Znanost o životu: Krvožilni sustav

* Istraživači na klinici Essen-Mitte u Njemačkoj nedavno su primijenili pijavice na 10 pacijenata koji su imali bolove u koljenu zbog osteoartritisa (degenerativne bolesti zglobova). Liječenje je ublažilo bol i upalu, ali američki liječnici kažu da je potrebno dodatno proučavanje prije nego što bi zagovarali terapiju pijavicama za artritis.

* Ljekovite pijavice, koje koštaju oko 7,50 USD svaka, mogu preživjeti mjesecima u hladnjaku sa slanom otopinom.

* Crvi izlučuju kemikaliju sličnu amonijaku koja ubija bakterije u rani.

Povijest: Neka učenici istraže i izvjeste o drugim neobičnim ljekovitim vjerovanjima i običajima u srednjem vijeku.

Kritičko razmišljanje: zmijski i pčelinji otrov, bijela glina, čak i med imaju trenutnu medicinsku uporabu. Odaberite jedan i istražite za što ga liječnici koriste.


Komplementarna i alternativna zdravstvena zaštita: temelji li se na dokazima?

Komplementarna i alternativna zdravstvena zaštita i medicinska praksa (CAM) skupina je različitih medicinskih i zdravstvenih sustava, praksi i proizvoda za koje se trenutno ne smatra da su dio konvencionalne medicine. Popis praksi koje se smatraju CAM -om neprestano se mijenja kako CAM prakse i terapije koje su se pokazale sigurnima i učinkovitima postaju prihvaćene kao “mainstream ” zdravstvene prakse. Danas se CAM prakse mogu grupirati u pet glavnih domena: alternativni medicinski sustavi, intervencije uma i tijela, biološki utemeljeni tretmani, manipulativne i tjelesne metode i energetske terapije.

TCM je sustav liječenja koji datira iz 200. godine prije Krista u pisanom obliku. Kina, Koreja, Japan, Indija i Vijetnam razvili su svoje jedinstvene verzije tradicionalne medicine. Alternativna medicina obično se zajedno s komplementarnom medicinom kategorizira pod krovnim izrazom ȁkomplementarna i alternativna medicina ”. Komplementarna medicina odnosi se na terapije koje nadopunjuju tradicionalnu zapadnu (ili alopatsku) medicinu i koriste se zajedno s konvencionalnom medicinom, a alternativna medicina koristi se umjesto konvencionalne medicine. Alternativna medicina odnosi se na terapijske pristupe koji se primjenjuju umjesto tradicionalne medicine i koriste se za liječenje ili poboljšanje bolesti. Integrativna medicina odnosi se na kombiniranje komplementarnih tretmana s konvencionalnom njegom. Temeljna filozofija komplementarne i alternativne medicine uključuje holističku skrb koja se fokusira na tretiranje ljudskog bića kao cjelovite osobe.

Primjeri komplementarnih i alternativnih medicinskih sustava liječenja uključuju Ayurvedu, koja je nastala u Indiji prije više od 5000 godina, naglašava jedinstveni lijek prema pojedinačnim okolnostima. Uključuje tretmane uključujući jogu, meditaciju, masažu, dijetu i bilje. Homeopatija koristi male doze tvari koja uzrokuje simptome kako bi potaknula tjelesni odgovor na samoizlječenje. Naturopatija se usredotočuje na neinvazivne tretmane kako bi pomogla vašem tijelu da ozdravi. Drevni lijekovi (komplementarni i alternativni lijekovi) uključuju prakse Kineza, Azije, Pacifika, Amerikanaca i Tibetana.

Konvencionalna medicina oslanja se na metode koje su se pokazale sigurnima i učinkovitima pomno osmišljenim ispitivanjima i istraživanjima. No, mnogim komplementarnim i alternativnim tretmanima nedostaju čvrsta istraživanja na kojima bi se mogle temeljiti zdrave odluke. Opasnosti i moguće koristi mnogih komplementarnih i alternativnih tretmana ostaju nedokazane.

Iako se cijeli medicinski sustav razlikuje u svojim filozofskim pristupima prevenciji i liječenju bolesti, oni imaju niz zajedničkih elemenata. Ovi sustavi temelje se na uvjerenju da jedno tijelo ima moć samoga sebe izliječiti. Liječenje često uključuje uspoređivanje više tehnika koje uključuju um, tijelo i duh. Liječenje je često individualno i ovisi o prisutnim simptomima.

Temeljna načela integrativne medicine uključuju partnerstvo između pacijenta i praktičara u procesu ozdravljenja, odgovarajuću uporabu konvencionalnih i alternativnih metoda za olakšavanje tjelesnog urođenog odgovora na ozdravljenje, razmatranje svih čimbenika koji utječu na zdravlje, dobrobit i bolest, uključujući um, duh i zajednicu kao i tijelo, filozofija koja niti odbacuje konvencionalnu medicinu niti prihvaća alternativno medicinu nekritički, priznanje da se dobra medicina treba temeljiti na dobroj znanosti, usmjerena na istraživanje i otvorena za nove paradigme, korištenje prirodnih, manje invazivnih metoda intervencije kad god je to moguće, šire koncepte promicanja zdravlja i prevencije bolesti, kao i liječenja bolesti. Studije su u tijeku kako bi se utvrdila sigurnost i korisnost mnogih CAM praksi. Kako se istraživanje nastavlja, postat će jasniji mnogi odgovori o tome jesu li ti tretmani sigurni ili učinkoviti.

Čini se da se uporaba alternativne medicine povećava. Studija iz 1998. pokazala je da je upotreba alternativne medicine u SAD -u porasla sa 33,8% 1990. na 42,1% 1997. godine [1]. Najčešće CAM terapije koje su se 2002. koristile u SAD -u bile su molitva (45,2%), travarstvo (18,9%), meditacija disanjem (11,6%), meditacija (7,6%), kiropraktika (7,5%), joga (5,1%), tjelesni rad (5,0%), terapija temeljena na prehrani (3,5%), progresivna relaksacija (3,0%), mega-vitaminska terapija (2,8%) i vizualizacija (2,1%) [2, 3]. Čini se da u Ujedinjenom Kraljevstvu ograničeni podaci podržavaju ideju da je upotreba CAM -a u Ujedinjenom Kraljevstvu velika i da se povećava.

Sve veći broj medicinskih fakulteta počeo je nuditi tečajeve alternativne medicine. Broj i popularnost akreditiranih naturopatskih koledža i sveučilišta u SAD -u raste. Oni nude najcjelovitiju medicinsku izobrazbu o besplatnim lijekovima koja je dostupna danas [4, 5]. U Britaniji niti jedna konvencionalna medicinska škola ne nudi tečajeve koji podučavaju kliničku praksu alternativne medicine. Međutim, alternativna medicina se uči u nekoliko nekonvencionalnih škola kao dio njihovog kurikuluma. Nastava se uglavnom temelji na teoriji i razumijevanju alternativne medicine, s naglaskom na komunikaciji sa specijalistima alternativne medicine.

Naturopatija (naturopatska medicina) je cijeli medicinski sustav koji ima korijene u Njemačkoj. Dodatno se razvila krajem 19. i početkom 20. stoljeća u Sjedinjenim Državama, gdje je danas dio CAM -a. Naturopatija ima za cilj podržati tjelesnu sposobnost da se izliječi korištenjem promjena u načinu prehrane i načina života zajedno s CAM terapijama, poput bilja, masaže i manipulacije zglobovima. Naturopatija je cijeli medicinski sustav. Ona bolest promatra kao manifestaciju promjena u procesima u kojima se tijelo prirodno liječi i naglašava obnovu zdravlja, a ne liječenje bolesti. Naturopatski liječnici koriste niz ljekovitih praksi, uključujući dijetu i kliničku prehranu, homeopatiju, akupunkturu, biljnu medicinu, hidroterapiju, manipulaciju kralježnice i mekih tkiva, fizikalne terapije koje uključuju električne struje, ultrazvuk i svjetlosnu terapiju, terapijsko savjetovanje i farmakologiju. Danas se naturopatija primjenjuje u brojnim zemljama, uključujući SAD, Kanadu, Veliku Britaniju, Australiju i Novi Zeland.

Akupunktura se prakticira za ublažavanje ili sprječavanje boli i za različita druga zdravstvena stanja. Pretkliničke studije dokumentirale su učinke akupunkture, ali nisu mogle u potpunosti objasniti kako akupunktura djeluje u okviru zapadnog medicinskog sustava.

Ayurveda, što doslovno znači "nauka o životu", prirodni je sustav liječenja razvijen u Indiji. To je opsežan medicinski sustav koji stavlja isti naglasak na tijelo, um i duh, te nastoji vratiti urođeni sklad pojedinca. Neki od primarnih ajurvedskih tretmana uključuju prehranu, tjelovježbu, meditaciju, bilje, masažu, izlaganje sunčevoj svjetlosti i kontrolirano disanje. Ajurvedski lijekovi mogu biti otrovni. Većina ajurvedskih lijekova sastoji se od kombinacija bilja i drugih lijekova, pa je teško znati koji lijekovi imaju učinak i zašto.

Ostale tradicionalne medicinske sustave razvile su domorodačke, aboridžinske, afričke, bliskoistočne, tibetanske, srednje i južnoameričke kulture.

Homeopatija je sustav medicinske teorije i prakse. Njegov utemeljitelj, njemački liječnik Samuel Christian Hahnemann (1755 �), postavio je hipotezu da se može izabrati terapija na temelju toga koliko se simptomi lijeka podudaraju sa simptomima pacijentove bolesti. To je nazvao “principom sličnosti ”. Budući da se homeopatija primjenjuje u malim ili potencijalno nepostojećim dozama materijala, u znanstvenoj zajednici postoji apriorni skepticizam o njezinoj učinkovitosti [6 𠄹].

Tradicionalna orijentalna medicina naglašava pravilnu ravnotežu ili poremećaje qija (izgovara se chi), odnosno vitalne energije u zdravlju, odnosno bolesti. Tradicionalna orijentalna medicina sastoji se od skupine tehnika i metoda, uključujući akupunkturu, biljnu medicinu, orijentalnu masažu i qi gong (oblik energetske terapije koji je dolje detaljnije opisan).

Naturopatija (naturopatska medicina) je cijeli medicinski sustav koji ima korijene u Njemačkoj. To je utjecalo na tjelesnu funkciju i simptome. Samo podskup intervencija uma i tijela smatra se CAM-om. Mnogi koji imaju dobro dokumentiranu teorijsku osnovu, na primjer, edukacija pacijenata i kognitivno-bihevioralni pristupi, sada se smatraju “mainstream ”. S druge strane, meditacija, određene uporabe hipnoze, plesa, glazbene i likovne terapije te molitva i mentalno ozdravljenje kategorizirane su kao komplementarne i alternativne.

Biofeedback je vrsta terapije uma i tijela. Koristeći povratne informacije iz različitih postupaka praćenja i opreme, stručnjak za biofidbek pokušat će vas naučiti kontrolirati određene nehotične reakcije tijela, kao što su: aktivnost mozga, krvni tlak, napetost mišića i broj otkucaja srca. Biofeedback se pokazao korisnim u liječenju nekoliko zdravstvenih stanja, uključujući astmu, Raynaudovu bolest, sindrom iritabilnog crijeva, inkontinenciju, glavobolje, srčane aritmije, visoki krvni tlak, epilepsiju itd.

Izraz meditacija odnosi se na različite tehnike ili prakse namijenjene usredotočivanju ili kontroliranju pažnje. Većina njih ukorijenjena je u istočnjačkim vjerskim ili duhovnim tradicijama. Ove se tehnike tisućama godina koriste u različitim kulturama diljem svijeta.

Ljudi su tisućama godina koristili molitvu i druge duhovne prakse za svoju i tuđu brigu o zdravlju. Znanstveno istraživanje ovih postupaka započelo je nedavno, no kako bi se bolje razumjelo djeluju li ako jesu, kako i za koje bolesti/stanja i populaciju. Mnogi Amerikanci koriste molitvu i druge duhovne prakse. Molitva je terapija koja se najčešće koristi među svim CAM terapijama.

Manipulativne i tjelesne prakse uključuju metode koje se temelje na manipulaciji i/ili kretanju tijela. Na primjer, kiropraktičari se usredotočuju na odnos između strukture (prvenstveno kralježnice) i funkcije te na to kako taj odnos utječe na očuvanje i obnovu zdravlja, koristeći manipulativnu terapiju kao integralni alat za liječenje. Terapeuti masaže manipuliraju mekim tkivima tijela kako bi normalizirali ta tkiva.

Energetske terapije usredotočene su ili na energetska polja koja potječu iz tijela (biopolja) ili na one iz drugih izvora (elektromagnetska polja). Terapije biopolja imaju za cilj utjecati na energetska polja čije postojanje još nije eksperimentalno dokazano, koja okružuju i prodiru u ljudsko tijelo. Neki oblici energetske terapije manipuliraju biopoljima pritiskom i/ili manipuliranjem tijelom stavljajući ruke u ta polja ili kroz njih. Primjeri uključuju Qi gong, Reiki, Pranu i Terapeutski dodir. Terapije temeljene na bioelektromagnetu uključuju nekonvencionalnu uporabu elektromagnetskih polja, poput impulsnih polja, magnetskih polja ili polja izmjenične struje ili istosmjerne struje, na primjer, za liječenje astme ili raka ili za upravljanje boli i migrenskim glavoboljama.

Hipnoza je promijenjeno stanje svijesti. Hipnoterapija ima potencijal pomoći u ublažavanju simptoma raznih bolesti i stanja. Može se koristiti samostalno ili zajedno s drugim tretmanima.

Prirodne i biološki utemeljene prakse, intervencije i proizvodi odnose se na uporabu dodataka prehrani i uključuju biljne, posebne dijetetske, ortomolekularne i individualne biološke terapije. Primjeri uključuju biljne sastojke, ekstrakte životinjskog podrijetla, vitamine, minerale, masne kiseline, aminokiseline, proteine ​​i prebiotike. Provedeno je tisuće studija o raznim dodacima prehrani. Međutim, niti jedan dodatak nije dokazano učinkovit na uvjerljiv način.

U Indiji, koja je dom nekoliko alternativnih sustava lijekova, Ayurveda, Siddha, Unani i Homeopatija licencirane su od strane vlade, unatoč nedostatku uglednih znanstvenih dokaza. Naturopatija će također uskoro biti licencirana jer nekoliko sveučilišta sada nudi diplome prvostupnika. Vlada sada licencira i druge aktivnosti poput Panchakarme i terapije masaže povezane s Ayurvedom [10].

Oko polovica opće populacije u razvijenim zemljama koristi CAM [10]. Istraživanje koje je u svibnju 2004. objavio Nacionalni centar za komplementarnu i alternativnu medicinu, dio Nacionalnog instituta za zdravlje u Sjedinjenim Državama, pokazalo je da je 2002. 36% Amerikanaca koristilo neki oblik alternativne terapije u posljednjih 12 mjeseci, 50 % u kategoriji života##x02014a koja je uključivala jogu, meditaciju, biljne tretmane i Atkinsovu dijetu. Većina pojedinaca (54,9%) koristila je CAM zajedno s konvencionalnom medicinom. Većina ljudi koristi CAM za liječenje i/ili sprječavanje mišićno -koštanih stanja ili drugih stanja povezanih s kroničnom ili ponavljajućom boli. Žene su češće od muškaraca koristile CAM. Najveći spolni razlika vidljiv je u upotrebi terapija uma i tijela, uključujući molitvu posebno iz zdravstvenih razloga [2, 3]. Ako se molitva računala kao alternativna terapija, brojka je porasla na 62,1%. 25% ljudi koji koriste CAM to čine zato što je to predložio liječnik [11]. Britansko telefonsko istraživanje BBC -a provedeno na 1.209 odraslih osoba 1998. godine pokazuje da je oko 20% odraslih osoba u Velikoj Britaniji koristilo alternativnu medicinu u posljednjih 12 mjeseci.

Zagovornici alternativne medicine smatraju da su različite alternativne metode liječenja učinkovite u liječenju širokog spektra velikih i manjih medicinskih stanja, te tvrde da je nedavno objavljeno istraživanje (Michalsen, 2003. Gonsalkorale, 2003. Berga, 2003.) dokazalo učinkovitost specifičnih alternativnih tretmana [ 6 𠄹].

Medicina zasnovana na dokazima (EBM) primjenjuje znanstvenu metodu u medicinskoj praksi i teži idealima koje bi zdravstveni radnici trebali koristiti savjesno, eksplicitno i promišljeno u svojoj svakodnevnoj praksi. Iako zagovornici alternativne medicine priznaju da placebo učinak može odigrati ulogu u koristima koje neki imaju od alternativnih terapija, ističu da to ne umanjuje njihovu valjanost. Smatraju da alternativna medicina može pružiti zdravstvene koristi osnaživanjem pacijenata, nudeći javnosti više izbora. Istraživači koji prosuđuju tretmane prema znanstvenoj metodi zabrinuti su zbog ovog gledišta, budući da ne uspijevaju riješiti moguću neučinkovitost alternativnih tretmana.

Sve dok se uz konvencionalne tretmane koriste alternativni tretmani, većina liječnika smatra da je većina oblika komplementarne medicine prihvatljiva. Consistent with previous studies, the CDC recently reported that the majority of individuals in the United States (i.e., 54.9%) used CAM in conjunction with conventional medicine.

The issue of alternative medicine interfering with conventional medical practices is minimized when it is turned to only after conventional treatments have been exhausted. Many patients feel that alternative medicine may help in coping with chronic illnesses for which conventional medicine offers no cure, only management. Classifying treatments need to be based on the objectively verifiable criteria of the scientific method evidence-based medicine, i.e. scientifically proven evidence of efficacy (or lack thereof), and not on the changing curricula of various medical schools or social sphere of usage [12] .

Since many alternative remedies have recently found their way into the medical mainstream, there cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted [13] .

It is argued that there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is �stern” or “Western”, is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues—namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy [14] . The Cochrane Collaboration [15] and Edzard Ernst [16] agree that all treatments, whether “mainstream” or 𠇊lternative”, ought to be held to standards of the scientific method.

Many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials in contrast, conventional drugs reach the market only after such trials have proved their efficacy. A person may attribute symptomatic relief to an otherwise ineffective therapy due to the placebo effect, the natural recovery from or the cyclical nature of an illness (the regression fallacy), or the possibility that the person never originally had a true illness [17] . CAM proponents point out this may also apply in cases where conventional treatments have been used. To this, CAM critics point out that this does not account for conventional medical success in double blind clinical trials.

People should be free to choose whatever method of healthcare they want, but stipulate that people must be informed as to the safety and efficacy of whatever method they choose. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. Grapefruit seed extract is an example of quackery when multiple studies demonstrate its universal antimicrobial effect is due to synthetic antimicrobial contamination [18, 19] .

Those who have had success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics contend that therapies that rely on the placebo effect to define success are very dangerous. Scientifically unsupported health practices can lead individuals to forgo effective treatments and this can be referred to as “opportunity cost”. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. More research must be undertaken to prove the effectiveness of complimentary therapies before they can be incorporated in formal medical practice. Sufficient evidence is required for biological or clinical plausibility in order to justify the investment of time and energy in exploring the merits of alternative medicine. After all, human life is precious and no chances can be taken to comprise the health of any individual.


The History of Wound Care

The history of wound healing is, in a sense, the history of humankind. This brief history of wound healing has been compiled for the benefit of readers. It is amazing to see that some of the basic principles of wound healing have been known since 2000 bc .

The history of wound healing is, in a sense, the history of humankind. One of the oldest medical manuscripts known to man is a clay tablet that dates back to 2200 bc . This tablet describes, perhaps for the first time, the “three healing gestures”—washing the wounds, making the plasters, and bandaging the wound.1,2,3

What the ancients and early moderns referred to as plasters is the present-day equivalent of wound dressings. These plasters were mixtures of substances including mud or clay, plants, and herbs. Plasters were applied to wounds to provide protection and to absorb exudate. One of the most common ingredients used in plasters was oil. Oil may have provided some protection from infection as bacteria grow poorly in oil, and oil would have prevented the bandage from sticking to the wound as a nonadherent dressing.1

One of the interesting earliest known wound care products was beer. The Sumerians brewed at least 19 different types of beer. An interesting prescription for wound healing described in Mesopotamian culture stated, “Pound together fur-turpentine, pine-turpentine, tamarisk, daisy, flour of inninnu strain mix in milk and beer in a small copper pan spread on skin bind on him, and he shall recover.𠇑

The Egyptians may have been the first people to use adhesive bandages and were most certainly the first people to apply honey to the wounds. Honey, grease, and lint were the main components of the most common plaster used by Egyptians. Lint made from vegetable fiber probably aided drainage of the wound grease and honey may have protected the wound from infection. Grease made from animal fat may have provided a barrier to bacteria. While honey appears to be an effective antibacterial agent, it has many other healing properties. Honey has been used for thousands of years and is still part of many advanced wound dressings. Honey was also used for wound care in India long before the time of Christ, demonstrating that separate medical cultures empirically arrived at the same successful therapy.1,4,5

Egyptians painted wounds with green color. Green indicates life, and green paint contains copper, which is toxic to bacteria. When most people think of ancient Egypt, they think of pyramids and mummies, and the art of wrapping the bodies of the dead probably influenced the bandaging of wounds. Also the art of preventing decomposition by embalming may have contributed to early advances in controlling infection.1,2

The Greeks stressed the importance of cleanliness. They recommended washing the wound with clean water, often boiled first, vinegar (acetic acid), and wine. The Greeks also differentiated between 𠇏resh,” or acute, and nonhealing, or chronic, wounds. One of the interesting excerpts from the Hippocratic collection about wound healing is, 𠇏or an obstinate ulcer, sweet wine and a lot of patience should be enough.” An early description of the 𠇏our cardinal signs of inflammation”—rubor, tumor, calor, et dolor (redness, swelling, heat, and pain)�me from the Romans.1,2,6,7

It was not until the 18th century that surgery began to be considered as a distinct and respected branch of medicine. In the 19th century, the antiseptic technique was a major breakthrough. The introduction of antibiotics helped control infections and decrease mortality.1,7,8

In the 20th century came the advent of modern wound healing. At the present time, there are more than 5,000 wound care products. Most modern dressings contain materials that are highly absorbent, such as alginates, foam, or carboxymethylcellulose. There are occlusive dressings and semiocclusive dressings. There are growth factors, advanced honey-based dressings, and hypochlorous acid�sed cleansers. Bioengineered tissue, negative pressure therapy, and hyperbaric oxygen therapy have changed the way we treat a lot of chronic wounds today.

There are more than 1,000 wound healing centers in the United States today, and wound healing has become a specialty, with fellowship programs offered at some academic centers.

In summary, The first wound treatments were described 5 millennia ago. Since then, various principles of wound care have been passed on from generation to generation. In contrast to large numbers of general technological inventions over the past 100 years, progress beyond ancient wound care practices is a recent phenomenon. It is essential to know the historical aspects of wound treatment (both successes and failures) in order to continue this progress and provide future direction.9


'Promising' treatment for diabetics

Dr Stadler said it was unfortunate that maggot therapy was perceived to be a last resort treatment in Australia.

"It is ideally suited for early interventions," he said.

"When someone presents with a diabetic ulcer, maggot therapy is fantastic in treating that ulcer and setting the wound up for healing."

Peter Lazzarini, a principal research fellow at QUT and co-chair of Diabetic Foot Australia, said a handful of small studies have tested maggot therapy on diabetic foot ulcer patients with mixed results.

"Maggot or larval therapy has been shown to be pretty effective in scientific labs at essentially gobbling up this devitalized tissue without touching the healthy ulcer tissue," he said.

"The rationale for using larval therapy is promising, but we need larger studies to prove if it is as effective, or more effective, than other forms of debridement yet."

While he has not used the technique on patients, Dr Lazzarini said he was aware of cases where it had been used for complex wounds where removing the tissue with a scalpel proved difficult.

"The larvae seem to be pretty good 𧷫riders' in these cases," he said.


Honey, Mud, Maggots and Other Medical Marvels: The Science Behind Folk Remedies and Old Wives' Tales

The actual remedies are interesting, unfortunately the writing is distractingly poor. I started skipping the last sentence of each chapter to avoid the inevitable atrocious puns that were lurking there. These are not clever puns (which may make you roll your eyes but still make you smile), these are groan out loud, painful and embarrassing to read Fozzie Bear caliber puns:
str. 30 " After all, maggot therapy didn&apost turn out to be such a flyblown idea, did it?"
pg: 70 "chalk up another success for The actual remedies are interesting, unfortunately the writing is distractingly poor. I started skipping the last sentence of each chapter to avoid the inevitable atrocious puns that were lurking there. These are not clever puns (which may make you roll your eyes but still make you smile), these are groan out loud, painful and embarrassing to read Fozzie Bear caliber puns:
str. 30 " After all, maggot therapy didn't turn out to be such a flyblown idea, did it?"
pg: 70 "chalk up another success for geopharmacy!" (chapter on eating soil, clay and dirt)
str. 86. "Far from absurd, bloodletting is proving itself to be a bloody good remedy"
Wocka Wocka Wocka!

I appreciate that they tried to make the subject matter fun and engaging, but I don't think it was successfully executed.

The chapter on circumcision is a soapbox the authors make their stance on the matter known and just repeat it for an entire chapter. (as another reviewer also noted, it feels totally out of place).

An entire chapter is devoted to how the development of medicine parallels Lamarckian evolution. eh?

The last few chapters feel like the first half of the book was put in a blender and just thrown back together in different configurations.

What's the difference between myself and an angler?
One hates this book.The other baits his hook. . više

Interesting info but the tone and the writing aren’t the best. The idea was sound, it’s helpful to understand what folk remedies can actually do beyond the placebo effect. The book is nicely organized, though the chapter order seems a bit of a hodge-podge. The writing is ok but the chapters are often repetitive within. The serious weakness of this book is the tone, it tends to give too much credit to folk remedies and their positive benefits without pointing out the obvious, much of the remedies Interesting info but the tone and the writing aren’t the best. The idea was sound, it’s helpful to understand what folk remedies can actually do beyond the placebo effect. The book is nicely organized, though the chapter order seems a bit of a hodge-podge. The writing is ok but the chapters are often repetitive within. The serious weakness of this book is the tone, it tends to give too much credit to folk remedies and their positive benefits without pointing out the obvious, much of the remedies are based on the placebo effect. While I found the info and argument for folk remedies convincing for limited purposes, I’m not sure the author really made that clear…they seem to be more focused on attacking the medical industry for not following up fully on these remedies. That said, the book did meet my expectations.

Still, I give this one a 3. I think the info is useful in limited contexts but I didn’t really enjoy the writing and agenda. By all means, ask your doctor about some of these ideas but, don’t do anything with this stuff yourself…I also think authors of post-apocalyptic works could benefit from this book…it’s what doctors would use to heal if modern medicine crumbled away.
. više

I found this book fascinating.

I must admit, I usually pick up nonfiction books with a bit of trepidation. Some of them are so dry, I fall asleep reading the intro. This book I could not set down though. I was fascinated by all the squirm-worthy and nasty cures in this book and the medical science behind them.

Until I read this, I could never understand why bleeding and leeches was such a popular cure for so long. Now I see that it was used to lower a fever and it actually worked. If only people I found this book fascinating.

I must admit, I usually pick up nonfiction books with a bit of trepidation. Some of them are so dry, I fall asleep reading the intro. This book I could not set down though. I was fascinated by all the squirm-worthy and nasty cures in this book and the medical science behind them.

Until I read this, I could never understand why bleeding and leeches was such a popular cure for so long. Now I see that it was used to lower a fever and it actually worked. If only people wouldn’t have taken so much blood, it might not have killed the patient. If you’re ever curious as to why people used to put urine in sleeping droughts, this book will tell you why.

This was a fast easy read and I whipped right through it. I have to laugh, because the atrocious puns that one reviewer complained about didn’t bother me at all. I rather thought it was a fun read. I was bit off though by the preachy chapter on circumcision. Consequently I knocked off a star.


The top 12 most amazing Israeli medical advances

Israeli ingenuity is responsible for some of the world’s most amazing medical advances.

Whether they’re futuristic, such as Given Imaging’s PillCam capsule endoscopy or Itamar Medical’s fingertip monitors for sleep disorders and cardiac issues — or cleverly simple, such as First Care Products’ Emergency Bandage – blue-and-white inventions are changing the face of healthcare in hospitals, doctors’ offices, homes and even battlefields worldwide.

“It’s almost a cliché to say Israel is an excellent place for medical innovation,” says Eran Perry, managing director at Israel Health Care Ventures (IHCV), one of the largest venture capital funds in the country.

“But if you look at [global] statistics, it’s evident — from total expenditure on civilian R&D, where we are ranked first to human infrastructure and entrepreneurship, where we rank in the top five. You can see the results in patents. We are first in the world for medical device patents per capita, and second in Europe for bio-pharma.”

About 1,000 Israeli companies are in healthcare or life-science products, including 700 in medical devices. Approximately half are already generating revenue.

“There has been an ecosystem created for life sciences, so these 1,000 companies don’t exist in a vacuum but in an environment where they have access to everything they need — engineering, labs, regulatory consultants, manufacturing consultants,” Perry tells ISRAEL21c. “Many young companies can be a one-man show until they get to the clinical trial stage, relying on this excellent ecosystem around them. You can see Israeli companies reaching the same stage as American ones with a fraction of the capital investment.”

IHCV reviews 200 to 300 new opportunities per year. Perry estimates that 60 to 70 Israeli healthcare companies are founded annually. Proceeds from mergers and acquisitions involving Israeli healthcare companies totalled around $1 billion in the past year.

That’s why ISRAEL21c had a hard time narrowing the field to this top 12 list of the most significant recent Israeli contributions to the medical field.

We have chosen products already on, or very near, the market. If you’ve got other companies you think also deserve a mention please don’t hesitate to add them to the comments section below.

And watch for a future top 10 list of the most exciting Israeli medical-device and pharmaceutical developments just around the corner.

And now … ISRAEL21c’s top 12 Israeli medical innovations, in alphabetical order.

1. ApiFix system to correct severe curvature of the spine (scoliosis) minimizes risks, scar size, complications, recovery time and cost. The miniature ratchet mechanism has successfully been implanted in 15 patients so far. Limited sales of the product have begun while clinical trials are in the last stages.

2. Argo Medical Technologies’ Rewalk robotic exoskeleton from was featured on the hit TV show “Glee” and enabled paraplegic runners in London and Tel Aviv to complete marathons. The ReWalk Rehabilitation model currently is used by patients in rehab centers from New York to Dusseldorf. ReWalk Personal, for everyday home use, is available throughout Europe and awaiting FDA clearance in the United States.

3. Gamida Cell is developing stem-cell therapy products to treat blood cancers, solid tumors, non-malignant blood diseases such as sickle-cell anemia, autoimmune diseases and genetic metabolic diseases. On Sept. 9, the first patient was successfully transplanted at Duke University Medical Center (North Carolina) in the second Phase I/II study of NiCord, Gamida’s experimental treatment for blood cancers.

4. GI View Aer-O-Scope disposable colorectal cancer screening device, now in US trials, will make lifesaving colonoscopy screenings cheaper, safer and more accessible worldwide. The self-navigating, flexible Aer-O-Scope removes the risk of perforating the colon, provides superior imaging and can be used by a trained nurse or technician so a gastroenterologist does not have to be present.

5. IceCure Medical’s IceSense3 has been used by US doctors since 2011 to remove benign breast lumps in a 10-minute ultrasound-guided procedure that penetrates the tumor and engulfs it with ice. The system is being clinically tested over the next few years against small malignant breast tumors as well. The procedure is done in a doctor’s office, clinic or breast center, and the patient can get up and leave afterward with no recovery period or post-care.

6. InSightec’s ExAblate OR uses MRI-guided focused ultrasound to destroy tumors and uterine fibroid cysts without surgery. The company has begun a Phase III trial of its next product, ExAblate Neuro, to cure essential tremor — a common movement disorder – using the same non-invasive technology to significantly lower risk of infection, hemorrhage and brain damage.

7. IonMed’s BioWeld1 bonds surgical incisions using cold plasma — instead of painful stitches, staples or glue – within minutes, sealing and disinfecting the wound with minimal scarring and recovery time. The CE Mark is expected in October, with European sales and US FDA approval process starting in early 2014.

8. Nano Retina’s Bio-Retina, a tiny implantable device inserted into the retina in a 30-minute procedure, turns into an artificial retina that melds to the neurons in the eye. Activated by special eyeglasses, the device transforms natural light into an electrical impulse that stimulates neurons to send images to the brain. The prototype is advancing quickly through clinical trials.

9. NanoPass Technologies’ MicronJet is a unique, FDA-approved single-use needle for painless delivery of vaccines into the skin using semiconductor technology. The product has been proven to generate superior immune response with less vaccine, because it does not go past the skin level. Licensed last year to Janssen Pharmaceuticals, MicronJet is being used by the US Center of Disease Control (CDC) in a large trial of polio vaccine for infants in Southeast Asia.

10. OrSense’s NBM-200 non-invasive monitor is relied upon by blood donation centers in 40 countries for continuous and spot measuring of potential donors’ hemoglobin level (to check for anemia) and other blood parameters. This device eliminates the need for finger pricking as well as biologically hazardous equipment and waste. Studies show that donors screened this way are more likely to become repeat blood donors. OrSense recently completed successful trials using its technology to detect hemorrhage and anemia in pregnant women.

11. Surpass Medical’s NeuroEndoGraft flow diverters redirect blood flow from a brain aneurysm (a bulge in a weak artery wall), so that a stable clot can form and the potentially fatal aneurysm no longer is in danger of rupturing. The family of devices has the CE Mark and has been used successfully in dozens of patients. US medical device manufacturer Stryker acquired Surpass for $100 million in October 2012.

12. VitalGo Systems’ Total Lift bed is the world’s only hospital-grade bed that can elevate a patient from a lying to a fully standing position — and all points in between — for treatment and transfer with no lifting required of the caregiver. Two major companies are distributing Total Lift in the acute-care and home-care markets in the United States.


The Medical Book by Clifford A. Pickover

Last year, I was treated to The Physics Book by Clifford A Pickover, which took a huge and sometimes-difficult subject and broke it down into delightful bite-sized pieces anyone can understand. This year, Dr. Pickover has done the exact same thing with an even more universal subject: health. U The Medical Book: From Witch Doctors to Robot Surgeons, there are 250 topics, one page each, with gorgeous illustrations. The topics are presented in more or less chronological order of the subject's discovery or a scientific breakthrough, so The Medical Book is also a history book. Flipping through the topics gives you a sense of how astonishingly recent our knowledge about how human bodies work really is.

Of the 250 topics, it was hard to select just a few to share, but these intrigued me. You'll find others in the book that particularly appeal to you.

10.000 godina prije Krista Witch Doctor

For thousands of years, human health, illness, and injury were all magical concepts.

Shamanic practices, involving healers who appear to be in contact with a spirit world, probably originated in Paleolithic (Old Stone Age) times. For example, evidence for Mesolithic (Middle Stone Age) shamanism was found in Israel in the form of an old woman from a burial dating to around 10,000 B.C. The importance of this woman, along with her possible close association with nature and animals, is suggested by the special arrangement of stones by her body, along with 50 complete tortoise shells, a human foot, and remains of birds, boars, leopards, cows, and eagles. Today, the vast majority of the traditional Nguni societies of southern Africa make use of sangomas who employ herbal medicine, divination, and counseling.

Thousands of years later, the science of human biology and the healing arts began to advance in fits and starts, through trial and error, involving a lot of misery on the way to enlightenment. But advance it did, and many of those discoveries are recorded in The Medical Book.

1346 Biological Weapons

Not all those advances were positive. An understanding of germ theory was not necessary to see the nefarious possibilities of contagious diseases, especially in causing harm to one's enemies.

Biological warfare has been conducted for millennia. In 184 B.C., the soldiers of Hannibal of Carthage threw clay pots filled with venomous snakes onto enemy ships. In 1346, Tatar forces threw warriors who died of plague over the walls of Kaffa, a Crimean city, and an outbreak of plague followed. In 1763, representatives of the Delaware Indians were given blankets exposed to smallpox. In 1940, Japanese warplanes flew over China and dropped ceramic bombs filled with fleas carrying bubonic plague.

Yet the goal most medical research is to help the sick and injured. Bodies were dissected, medicines tried, patients suffered and died, and scientists and physicians built upon the knowledge of those who came before.

1683 The Zoo Within Us

Dutch microbiologist Anton Philips van Leeuwenhoek built his own microscope and studied his own body. In 1683, he observed "little living animalcules" in scrapings of his dental plaque. This discovery led to our knowledge of the human microbiome, in which a diverse collection of microbes help our bodies function.

Beneficial and harmful microbes typically reside on and in the skin, mouth, gastrointestinal tract, vagina, nose, and other various orifices. More than 500 species of bacteria live in the human intestines, motivating researchers to think of this population as comprising a "virtual organ." The creatures in our gut can ferment food to aid in digestion, produce vitamins for our bodies, and prevent the growth of harmful species. Such bacteria rapidly colonize a baby's intestines starting from birth.

Hail, hail, the gang's all here -whether you like it or not!

1929 Maggot Therapy

1929 was a banner year for medical discoveries and breakthroughs, and there are quite a few labeled with that year in The Medical Book. One is maggot therapy. Maggots, or fly larvae, had been observed to clean and debride wounds since antiquity, but it was American physician William Baer who tried applying maggots deliberately to infected wounds.

During World War I, Baer had observed a soldier who remained on the battlefield for days with many serious wounds. Back at the hospital, when the soldier's clothes were removed, Baer saw "thousands and thousands" of maggots in the wounds. Surprisingly, the soldier exhibited no fever and had healthy pink tissue in the wounds. These experiences led Baer, in 1929, to apply maggots to the tissue of patients with intractable chronic osteomyelitis (infection of the bone). The maggots worked miracles, and Baer noticed rapid debridement (removal of dead, damaged, or infected tissues), reduction in the number of disease-causing organisms, reduced odor, and rapid rates of healing.

The next time the subject of maggot therapy comes up and someone inevitably says, "Now, what on earth ever gave someone the notion to try that?", you can set them straight --it was based on previous observations of what occasionally happens naturally.

1946 Cancer Chemotherapy

As medical science built on previous research, advances in healing began to take marvelous leaps forward. When cancer was found to be caused by the uncontrolled growth of cells, scientists confronted the problem of how to stop those cells without killing our healthy cells at the same time. It took a tragedy to point them in the right direction.

Surprisingly, one of the first effective anticancer drugs was discovered when American pharmacologists Alfred Gilman and Lewis Goodman performed research, under the cloak of wartime secrecy, after more than 1,000 people were accidently exposed to American-made mustard gas bombs. This chemical warfare agent was found to damage rapidly-growing white blood cells, and scientists reasoned that this might be useful for treating certain lymphomas (cancers of certain white blood cells). When a patient with non-Hodgkin's lymphoma was injected with a related nitrogen compound in 1943, Gilman and Goodman observed a dramatic but temporary shrinkage of the tumor masses. The government gave Gilman and Goodman permission to publish their findings in 1946.

That observation and subsequent experiments opened the floodgates to many different chemotherapy regimens that have been developed since then and are used all over the world today.

1961 Self-Surgery

There are pages in which The Medical Book steps sideways and presents stories that will curl your hair. As fascinating as medical advances and discoveries are, those stories pale beside the tales of a select group of people who have performed surgery on themselves.

For example, on April 30, 1961, Russian general practitioner Leonid Rogozov removed his own infected appendix at the Soviet Novolazararevskaya Research Station in Antarctica. This surgery was probably the first successful self-appendectomy undertaken beyond a hospital setting, with no possibility of outside assistance, and with no other medical personnel present. Prior to his surgery, Rogozov recorded in his journal: "I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals. I have to think through the only possible way out: to operate on myself. It's almost impossible. but I can't just fold my arms and give up."

Luckily, Rogozov recovered completely, but his story is only one of several self-surgeries related in the book.

The Medical Book is a wonderful resource on what we've learned and when and how we learned about our own health. The oh-so-useful way the book is presented makes it a delightful and appropriate gift for readers of all ages who like to take a break and learn something new and interesting. Who knows --you may find yourself reading it all the way through at once! The Medical Book: From Witch Doctors to Robot Surgeons, 250 Milestones in the History of Medicine is available now at Amazon, Barnes & Noble, and at a bookstore near you. Visit author Clifford A Pickover at his website and at Cliff Pickover's Reality Carnival. He also likes to Tweet.


HEALTH Healing Treatment, 4,000 Years Old, Is Revived

To help heal seriously infected wounds, some surgeons have revived a 4,000-year-old treatment, born on the battlefields of ancient Egypt: they pack the depths of treacherous wounds with sweet substances like sugar.

Dressings made of sugar and honey, favored by healers throughout history, fell into disfavor with the development of antibiotics over half a century ago. But even the most sophisticated modern preparations have proved unable at times to overcome the hearty bacteria that live in deep wounds, and a handful of doctors, mostly in Europe, are turning once again to sugar ''It's a very old and very simple treatment which was forgotten for a while but is now coming back, like a fashion,'' said Prof. Rudy Siewert, chairman of the department of surgery at the Klinikum Rechts der Isar in Munich, West Germany.

Renaissance vs. Skepticism

Professor Siewert said that in the last five years the technique had enjoyed a wide renaissance in Germany and to a lesser extent in the rest of Europe. Despite the interest abroad, most American surgeons express mild skepticism.

'ɿor the right kind of wound it works fine, and it's fun to look at an ancient remedy,'' said Dr. Mary H. McGrath, chief of the division of plastic surgery at the George Washington University Medical Center in Washington, D.C. Doctors there have used sugar to treat uninfected bedsores. 'ɻut there are about 600 lotions and potions for healing wounds, and I think you can get a lot more effect with our contemporary local antibacterials.''

Experts say the ancient treament probably works because sugar tends to draw water into its gritty midst, through osmosis. This action both dries the bed of the wound to promote new tissue growth and dehydrates the bacteria that cause infection, leaving them weak and fragile. Several American pharmaceutical concerns make expensive wound pastes composed of synthetic microscopic water-absorbing beads that perform this same function. Revival Began in U.S. Although sugar dressings have few American advocates, Europeans ascribe the current revival in part to the work of an American, Dr. Richard A. Knutson, an orthopedic surgeon in Greenville, Miss., who published one of the few papers on the technique a decade ago.

About 15 years ago, frustrated by stubborn, pus-filled wounds filled with bacteria resistent to all drugs, Dr. Knutson began experimenting with sugar dressings at the suggestion of a retired nurse who had worked in the Deep South before the antibiotic era.

''When we started I thought it was absolutely nuts,'' Dr. Knutson said in a recent telephone interview. ''Sugar! The first thing you think about is the old jar of marmalade in the fridge growing all that junk. You think you'll create a perfect medium for bacterial growth. That turned out not to be the case.''

He has since used a salve made of sugar, which he now mixes with a mild bacteria-killing iodine liquid, on about 6,000 patients with anything from burns to shotgun wounds. The mixture is applied as a paste. ''It's easy to use, painless, inexpensive, and it works,'' he said, ''You can't ask for more. If it has a fancy name and cost $300 a bottle everyone would be buying it.'' Most European surgeons use sugar alone.

The care of deep wounds is a major challenge to surgeons. Although doctors sew up small clean cuts, the skin above penetrating injuries that are likely to be infected is generally left open, both to allow the doctors to clean the cavity and to allow the body to grow new tissue, called granulation tissue, from the deep wound base.

Over weeks to months, the wound becomes sterile and slowly fills with new tissue. Systemic antibiotics are often required to aid the healing process. Sometimes skin and muscle must be surgically moved from other parts of the body to cover areas that would otherwise never completely heal.

Using the resurrected technique, doctors alter the usual cleaning regimen by sprinkling granulated sugar or spreading sugar paste in the wound two to four times a day, before applying new bandages. The sugar liquefies somewhat as it absorbs fluid from the wound, so it is simple to rinse out the sugar, along with dead tissue, at the next dressing change.

Doctors who use the method say that even dirty injuries are often germ-free after several days and that wounds seem to heal faster and more completely than with conventional treatments.

''The granulation tissue is much pinker and healthier,'' said Dr. B. G. Spell, a surgeon at the Methodist Rehabilitation Hospital in Jackson, Miss., who says he uses the technique daily to heal infected amputations and the deep pressure sores that plague paraplegics. ''The dead tissue breaks down more easily, so there's not as much debridement,'' he said.

In a series of articles in the British medical journal Lancet over the last five years, doctors at various European medical centers have reported success using the technique in a variety of situations in which nothing else worked. Dr. J. L. Trouillet at the Hopital Bichat in Paris described using granulated sugar bought from a supermarket for successful treatment of 19 critically ill cardiac surgery patient who had mediastinitis, a frequently deadly infection of the compartment in the chest that contains the heart.

Patients expecting high-tech medicine are often surprised to find their injuries sweetened. ''The doctors had mentioned that they were going to use 'wound sugar,' but it didn't register,'' said John Tagliabue, a New York Times reporter who was shot and seriously wounded last December while covering the revolution in Romania.

His wound was packed with sugar at the Klinikum in Munich, where he was moved for treatment. ''One day I noticed this sandy material on the sheets, like crumbs from eating cookies in bed.'' he said. ''Then it hit me: They really meant sugar.''

Will the enthusiasm for the revival spread to the Americas? ''There are better treatments these days,'' said Dr. McGrath, in an opinion that half a dozen prominent American surgeons echoed in interviews. Dr. McGrath's own research includes studying the effect of molecules called growth factors, manufactured by genetically altering organisms, on a type of cell involved in healing.

''Over all, I think the Europeans are a little less rigorous in their journals,'' she said. And, in truth, despite nearly 4,000 years of use, there are no comparative scientific studies of sugar dressings to be found.

But Professor Siewert has a slightly different take on the issue. ''The American way is more scientific,'' he said, ''The European way sometimes comes more from history and experience. That's good, too.''

Other Remedies From History

Until a century ago, doctors applied leeches for almost every illness in the mistaken belief that they would draw out '𧮭 blood.'' Today they are used after microsurgery that reattaches fingers, toes and other body parts. An operation can fail because tiny blood vessels become clogged. But when a small European leech, Hirudo medicinalis, is attached, it sucks out an ounce or two of blood from the clogged vessels. The leech's saliva containes an anticoagulant and an antiseptic.

Maggots, fly larvae, once allowed to clean festering battlefield wounds, have been used to save the legs of a 17-year-old girl who developed a blood infection that caused clotting in her legs. Oral antibiotics could not reach the sores, so physicians at Children's Hospital in Washington D.C., applied 1,500 maggots. They ate away dead skin while allowing healthy skin to thrive.

Scientists have also validated a folk remedy for cuts used by Arab fishermen. The Arabian saltwater catfish, Arius bilineatis, secretes a slimy, gellike substance that contains proteins that coagulate blood to stop bleeding and enzymes that speed the growth of new tissue.


Band-Aids

It may seem odd to consider anything adorned with Rugrats or Spider-Man as a medicine-changing tool, but don’t make the mistake of dismissing Band-Aids simply because they can be cute. Huge numbers of people see the world’s first self-adhesive bandages not just as temporary fixes but, rather, a device helping put the care into health care.

A caring cotton buyer for Johnson & Johnson (Band-Aids’ maker) invented them in 1920 so he could tend to the many cuts and minor burns his beloved and accident-prone wife got while cooking and keeping house.

By 1942, millions of Johnson & Johnson’s adhesive bandages accompanied World War II soldiers overseas. In 1963, Mercury astronauts took them into space. Back here on Earth, Band-Aids became the go-to therapy for parents wanting to make boo-boos better.

They act as medals for bravery in the face of inoculations, they hide the tear-inducing sight of a skinned knee, and they actually do help minor wounds heal better with fewer scars and infections. Turns out, we really are stuck on Band-Aids. By 2001, the number manufactured had rocketed past 100 billion.


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